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https://www.readbyqxmd.com/read/28328670/the-trauma-ecosystem-the-impact-and-economics-of-new-trauma-centers-on-a-mature-statewide-trauma-system
#1
David J Ciesla, Etienne E Pracht, Pablo T Leitz, David A Spain, Joseph J Tepas, Kristan L Staudenmayer
INTRODUCTION: Florida serves as a model for the study of trauma system performance. Between 2010 and 2104, 5 new trauma centers were opened along side 20 existing centers. The purpose of this study was to explore the impact of trauma system expansion on system triage performance and trauma center patient profiles. METHODS: A statewide dataset was queried for all injury related discharges from adult acute care hospitals using ICD-9 codes for 2010 and 2014. The dataset, inclusion criteria, and definitions of high-risk injury were chosen to match those used by the Florida department of health in its trauma registry...
March 20, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28322095/therapeutic-inertia-and-intensified-treatment-in-diabetes-mellitus-prescription-patterns-a-nationwide-population-based-study-in-taiwan
#2
Li-Ying Huang, Hseng-Long Yeh, Ming-Chin Yang, Wen-Yi Shau, Syi Su, Mei-Shu Lai
Objective To measure therapeutic inertia by characterizing prescription patterns using secondary data obtained from the nationwide diabetes mellitus pay-for-performance (DM-P4P) programme in Taiwan. Methods Using reimbursement claims from Taiwan's National Health Insurance Research Database, a nationwide retrospective cohort study was undertaken of patients with diabetes mellitus who participated in the DM-P4P programme from 2006-2008. Glycosylated haemoglobin results were used to evaluate modifications in therapy in response to poor diabetes control...
December 2016: Journal of International Medical Research
https://www.readbyqxmd.com/read/28321019/myocardial-infarction-in-a-young-man-with-nephrotic-syndrome
#3
Zhenliang Chu, Hang Zhu, Bin Zhang, Liqin Jiang
A 26-year-old man diagnosed with nephrotic syndrome (NS) 2 years previously presented with chest pain. An electrocardiogram (ECG) performed at a local hospital showed ST-elevation in chest leads. Cardiac troponin-I was significantly positive. Echocardiography revealed mild regional wall-motion abnormalities in the heart apex. Seven days later, angiography (CAG) revealed a thrombus in the left anterior descending branch (LAD). Tirofiban was injected into the LAD for thromboclasis. ECG after CAG showed the ST-segment was much lower than before...
March 17, 2017: International Heart Journal
https://www.readbyqxmd.com/read/28320075/a-cost-utility-analysis-of-high-molecular-weight-hyaluronic-acid-for-knee-osteoarthritis-in-everyday-clinical-care-in-patients-in-the-working-age-an-economic-evaluation-of-a-randomized-clinical-trial
#4
Job Hermans, Max Reijman, Lucas Ma Goossens, Hennie Verburg, Sita Ma Bierma-Zeinstra, Marc A Koopmanschap
Objectives Knee osteoarthritis (OA) is associated with high medical costs and especially with high productivity costs, in particular in patients in their working years. High molecular weight (HMW) hyaluronic acid (HA) is an alternative treatment for non-steroidal anti-inflammatory drugs (NSAIDs), which are known for their serious side-effects. The cost-utility of intra-articular HMW-HA treatment in these patients is unknown though and was assessed in this study. Methods Secondary care patients between 18 and 65 with knee OA were randomized to usual care (UC) + HMW-HA (intervention group) or UC only (control group)...
March 20, 2017: Arthritis Care & Research
https://www.readbyqxmd.com/read/28318606/on-the-role-of-environmental-corruption-in-healthcare-infrastructures-an-empirical-assessment-for-italy-using-dea-with-truncated-regression-approach
#5
Marina Cavalieri, Calogero Guccio, Ilde Rizzo
OBJECTIVES: This paper investigates empirically whether the institutional features of the contracting authority as well as the level of 'environmental' corruption in the area where the work is localised affect the efficient execution of public contracts for healthcare infrastructures. METHODS: A two-stage Data Envelopment Analysis (DEA) is carried out based on a sample of Italian public contracts for healthcare infrastructures during the period 2000-2005. First, a smoothed bootstrapped DEA estimator is used to assess the relative efficiency in the implementation of each single infrastructure contract...
February 27, 2017: Health Policy
https://www.readbyqxmd.com/read/28316543/performing-economic-evaluation-of-integrated-care-highway-to-hell-or-stairway-to-heaven
#6
Apostolos Tsiachristas, K Viktoria Stein, Silvia Evers, Maureen Rutten-van Mölken
Health economists are increasingly interested in integrated care in order to support decision-makers to find cost-effective solutions able to tackle the threat that chronic diseases pose on population health and health and social care budgets. However, economic evaluation in integrated care is still in its early years, facing several difficulties. The aim of this paper is to describe the unique nature of integrated care as a topic for economic evaluation, explore the obstacles to perform economic evaluation, discuss methods and techniques that can be used to address them, and set the basis to develop a research agenda for health economics in integrated care...
October 19, 2016: International Journal of Integrated Care
https://www.readbyqxmd.com/read/28306149/medicare-access-and-chip-reauthorization-act-what-do-geriatrics-healthcare-professionals-need-to-know-about-the-quality-payment-program
#7
Kathleen T Unroe, Peter A Hollmann, Alanna C Goldstein, Michael L Malone
Commencing in 2017, the Medicare Access and CHIP Reauthorization Act (MACRA) of 2015 will change how Medicare pays health professionals. By enacting MACRA, Congress brought an end to the (un)sustainable growth rate formula while also setting forth a vision for how to transform the U.S. healthcare system so that clinicians deliver higher-quality care with smarter spending by the Centers for Medicare and Medicaid Services (CMS). In October 2016, CMS released the first of what stakeholders anticipate will be a number of (annual) rules related to implementation of MACRA...
March 17, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28302164/cost-effectiveness-of-cerebrospinal-biomarkers-for-the-diagnosis-of-alzheimer-s-disease
#8
Spencer A W Lee, Luciano A Sposato, Vladimir Hachinski, Lauren E Cipriano
BACKGROUND: Accurate and timely diagnosis of Alzheimer's disease (AD) is important for prompt initiation of treatment in patients with AD and to avoid inappropriate treatment of patients with false-positive diagnoses. METHODS: Using a Markov model, we estimated the lifetime costs and quality-adjusted life-years (QALYs) of cerebrospinal fluid biomarker analysis in a cohort of patients referred to a neurologist or memory clinic with suspected AD who remained without a definitive diagnosis of AD or another condition after neuroimaging...
March 16, 2017: Alzheimer's Research & Therapy
https://www.readbyqxmd.com/read/28301684/economic-evaluation-of-nivolumab-as-a-second-line-treatment-for-advanced-renal-cell-carcinoma-from-us-and-chinese-perspectives
#9
Xiao Min Wan, Liu Bao Peng, Jin An Ma, Yuan Jian Li
BACKGROUND: Nivolumab is a new standard of care for patients with metastatic renal cell carcinoma (mRCC) and provides an overall survival benefit of 5.40 months in comparison with everolimus. This study evaluated the cost-effectiveness of nivolumab for the second-line treatment of mRCC from the perspective of US payers and identified the range of drug costs for which the addition of nivolumab to standard therapy could be considered cost-effective from a Chinese perspective. METHODS: A partitioned survival model was constructed to estimate lifetime costs, life-years, and quality-adjusted life-years (QALYs)...
March 16, 2017: Cancer
https://www.readbyqxmd.com/read/28300990/analysis-of-the-attributes-of-primary-health-care-using-the-electronic-medical-records-in-the-city-of-rio-de-janeiro
#10
Daniel Soranz, Luiz Felipe Pinto, Luiz Antonio Bastos Camacho
Epidemiology plays a strategic role at this stage of the policy cycle, contributing to goal setting, resource allocation and use of information systems. In 2009, the Municipal Health Secretariat of Rio de Janeiro initiated a reform of the health care model under the main influence the Primary Health Care concept. This study evaluates the trend of selected pay-for-performance indicators that measure the health care process in the city's PHC. This a study on repeated panels, from the administrative and clinical records of electronic medical records in the period from 2012 to 2016...
March 2017: Ciência & Saúde Coletiva
https://www.readbyqxmd.com/read/28300976/primary-health-care-reform-in-the-cities-of-lisbon-and-rio-de-janeiro-context-strategies-results-learning-and-challenges
#11
Daniel Soranz, Luís Augusto Coelho Pisco
On the 30th anniversary of Alma-Ata, the World Health Organization published in 2008 the "Primary Health Care Now More Than Ever" Report, calling on all governments to reflect on the need to reflect on four sets of reforms. These included: (i) universal coverage reforms; (ii) service delivery reforms; (iii) public policies reforms that would ensure healthier communities; and (iv) leadership reforms. In this context, in the period 2005-2016, the cities of Rio de Janeiro and Lisbon developed a profound primary healthcare reform, and did so by sharing many of the solutions based on the best internationally recognized organizational practices...
March 2017: Ciência & Saúde Coletiva
https://www.readbyqxmd.com/read/28300048/cardiovascular-responses-to-millet-pounding-activity-among-women-in-a-rural-community-in-northeastern-nigeria
#12
Adetoyeje Y Oyeyemi, Fati Jajimaji, Adewale L Oyeyemi, Abdul-Hameed A Jabbo
BACKGROUND: Pounding food items in a wooden mortal is a common home chore in many communities in African and Asian countries. However, no empirical data exist on energy expenditure during this activity, and whether the activity can be considered a light, moderate, or vigorous intensity physical activity is unknown. PURPOSE: This study was aimed at gaining insights into energy expenditure during millet pounding through cardiovascular responses to millet pounding activity, and to explore possible differences in response between women who pound millet as their occupation (habitual millet pounders) and those who pound millet only for their own home cooking but not as a job (nonhabitual pounders)...
January 2017: Annals of African Medicine
https://www.readbyqxmd.com/read/28299322/semantic-health-knowledge-graph-semantic-integration-of-heterogeneous-medical-knowledge-and-services
#13
Longxiang Shi, Shijian Li, Xiaoran Yang, Jiaheng Qi, Gang Pan, Binbin Zhou
With the explosion of healthcare information, there has been a tremendous amount of heterogeneous textual medical knowledge (TMK), which plays an essential role in healthcare information systems. Existing works for integrating and utilizing the TMK mainly focus on straightforward connections establishment and pay less attention to make computers interpret and retrieve knowledge correctly and quickly. In this paper, we explore a novel model to organize and integrate the TMK into conceptual graphs. We then employ a framework to automatically retrieve knowledge in knowledge graphs with a high precision...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28298324/the-esrd-quality-incentive-program-can-we-bridge-the-chasm
#14
Daniel Weiner, Suzanne Watnick
The ESRD Quality Incentive Program (QIP) is the first mandatory federal pay for performance program launched on January 1, 2012. The QIP is tied to the ESRD prospective payment system and mandated by the Medicare Improvements for Patients and Providers Act of 2008, which directed the Centers for Medicare and Medicaid Services to expand the payment bundle for renal dialysis services and legislated that payment be tied to quality measures. The QIP links 2% of the payment that a dialysis facility receives for Medicare patients on dialysis to the facility's performance on quality of care measures...
March 15, 2017: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/28293016/umbilical-pilonidal-sinus-an-underestimated-and-little-known-clinical-entity-report-of-two-cases
#15
Mehmet Kaplan, Elif Tugce Kaplan, Tugba Kaplan, Fatma Cigdem Kaplan
BACKGROUND Umbilical pilonidal sinus (UPS) is a rare disease of young, hirsute, dark men with deep navels and poor personal hygiene. UPS could easily be misdiagnosed and mistreated due to its rarity and lack of awareness of the condition by physicians. However, the diagnosis is easy to establish with physical examination and a detailed history. Although it is being diagnosed and reported more frequently, there is still no consensus regarding best treatment options. CASE REPORT In this report, we present two cases of UPS, one in a man and one in a woman, who had typical symptoms of pain, swelling, and intermittent malodorous discharge from the umbilicus...
March 15, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28291545/adding-bevacizumab-to-single-agent-chemotherapy-for-the-treatment-of-platinum-resistant-recurrent-ovarian-cancer-a-cost-effectiveness-analysis-of-the-aurelia-trial
#16
Weiya Z Wysham, Elisabeth M Schaffer, Theresa Coles, Dario R Roque, Stephanie B Wheeler, Kenneth H Kim
OBJECTIVE: AURELIA, a randomized phase III trial of adding bevacizumab (B) to single agent chemotherapy (CT) for the treatment of platinum-resistant recurrent ovarian cancer, demonstrated improved progression free survival (PFS) in the B+CT arm compared to CT alone. We aimed to evaluate the cost effectiveness of adding B to CT in the treatment of platinum-resistant recurrent ovarian cancer. METHODS: A decision tree model was constructed to evaluate the cost effectiveness of adding bevacizumab (B) to single agent chemotherapy (CT) based on the arms of the AURELIA trial...
March 10, 2017: Gynecologic Oncology
https://www.readbyqxmd.com/read/28291431/is-it-possible-to-avoid-intra-articular-screw-penetration-with-minimal-use-of-fluoroscopy-in-the-application-of-distal-radius-volar-plate
#17
Cengiz Aldemir, Fatih Duygun
OBJECTIVES: This study aims to investigate whether or not it is possible to avoid intra-articular screw penetration in the application of distal radius volar plate with minimal use of fluoroscopy and thereby reduce to a minimum the risk of exposure of the surgical team to radiation. PATIENTS AND METHODS: Volar plate with distal screw application with minimal use of fluoroscopy was performed in a total of 50 patients (22 males, 28 females; mean age 43.52 years; range 18 to 76 years) with unstable distal radius fracture following reduction of fracture between June 2014 and May 2016...
April 2017: Eklem Hastalıkları Ve Cerrahisi, Joint Diseases & related Surgery
https://www.readbyqxmd.com/read/28283721/the-importance-of-blumensaat-s-line-morphology-for-accurate-femoral-acl-footprint-evaluation-using-the-quadrant-method
#18
Yoshiyuki Yahagi, Takanori Iriuchishima, Takashi Horaguchi, Makoto Suruga, Yasuaki Tokuhashi, Shin Aizawa
PURPOSE: The purpose of this study was to evaluate the difference in the center position of the ACL footprint based on grid placement using the quadrant method according to the morphological variations of the Blumensaat's line. METHODS: Fifty-nine non-paired human cadaver knees were used. The ACL was cut in the middle, and the femoral bone was cut at the most proximal point of the femoral notch, and the digital images were evaluated using Image J software. The femoral ACL footprint was periphery outlined and the center position was automatically measured...
March 10, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28283236/cost-effectiveness-of-mediastinal-lymph-node-staging-in-non-small-cell-lung-cancer
#19
Katarzyna Czarnecka-Kujawa, Ursula Rochau, Uwe Siebert, Eshetu Atenafu, Gail Darling, Thomas Kenneth Waddell, Andrew Pierre, Marc De Perrot, Marcelo Cypel, Shaf Keshavjee, Kazuhiro Yasufuku
OBJECTIVE: To assess the cost-effectiveness of various modes of mediastinal staging in non-small cell lung cancer (NSCLC) in a single-payer health care system. METHODS: We performed a decision analysis to compare the health outcomes and costs of 4 mediastinal staging strategies: no invasive staging, endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA), mediastinoscopy, and EBUS-TBNA followed by mediastinoscopy if EBUS-TBNA is negative. We determined incremental cost effectiveness ratios (ICER) for all strategies and performed comprehensive deterministic sensitivity analyses using a willingness to pay threshold of $80,000/quality adjusted life year (QALY)...
February 9, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28283140/pay-matters-the-piece-rate-and-health-in-the-developing-world
#20
Mary E Davis
BACKGROUND: Piece rate pay remains a common form of compensation in developing-world industries. While the piece rate may boost productivity, it has been shown to have unintended consequences for occupational safety and health, including increased accident and injury risk. OBJECTIVES: This paper explores the relationship between worker pay and physical and emotional health, and questions the modern day business case for piece rate pay in the developing world. METHODS: The relationship between piece rate and self-reported measures of physical and emotional health is estimated using a large survey of garment workers in 109 Vietnamese factories between 2010 and 2014...
September 2016: Annals of Global Health
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